Callum K, Graune C, Bowman E, Molden E, Leslie SJ. Remote monitoring of implantable defibrillators is associated with fewer inappropriate shocks and reduced time to medical assessment in a remote and rural area. World J Cardiol 2021; 13(3): 46-54 [PMID: 33791078 DOI: 10.4330/wjc.v13.i3.46]
Corresponding Author of This Article
Stephen J Leslie, BSc, FRCP, MBChB, PhD, Professor, Department of Cardiology, NHS Highland, Old Perth Road, Inverness IV2 3UJ, United Kingdom. stephen.leslie@nhs.scot
Research Domain of This Article
Cardiac & Cardiovascular Systems
Article-Type of This Article
Retrospective Cohort Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Cardiol. Mar 26, 2021; 13(3): 46-54 Published online Mar 26, 2021. doi: 10.4330/wjc.v13.i3.46
Remote monitoring of implantable defibrillators is associated with fewer inappropriate shocks and reduced time to medical assessment in a remote and rural area
Kara Callum, Claudia Graune, Elizabeth Bowman, Edward Molden, Stephen J Leslie
Kara Callum, Claudia Graune, Elizabeth Bowman, Edward Molden, Stephen J Leslie, Department of Cardiology, NHS Highland, Inverness IV2 3UJ, United Kingdom
Author contributions: Callum K wrote the first draft; all authors were involved in data collection and contributed to the final submission.
Institutional review board statement: This study was given Caldicott approval by the director of Public Health, NHS Highland.
Informed consent statement: Patients are not required to sign informed consent.
Conflict-of-interest statement: None of the authors have any conflicts of interest.
Data sharing statement: None.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Stephen J Leslie, BSc, FRCP, MBChB, PhD, Professor, Department of Cardiology, NHS Highland, Old Perth Road, Inverness IV2 3UJ, United Kingdom. stephen.leslie@nhs.scot
Received: June 8, 2020 Peer-review started: June 8, 2020 First decision: October 21, 2020 Revised: January 13, 2021 Accepted: March 8, 2021 Article in press: March 8, 2021 Published online: March 26, 2021
ARTICLE HIGHLIGHTS
Research background
Implantable cardioverter defibrillators (ICDs) and cardiac resynchronisation therapy with defibrillators (CRT-D) reduce mortality in certain cardiac patient populations. However, inappropriate shocks pose a problem, having both adverse physical and psychological effects on the patient. The advances in device technology now allow remote monitoring (RM) of devices to replace clinic follow up appointments. This allows real time data to be analysed and actioned and this may improve patient care.
Research motivation
This is because inappropriate shocks and delayed assessment can lead to morbidity and reduced quality of life for patients.
Research objectives
The primary objective was to determine if RM in patients with an ICD is associated with fewer inappropriate shocks and reduced time to medical assessment.
Research methods
This was a single centre, retrospective observational study, involving 156 patients implanted with an ICD or CRT-D, followed up for 2 years post implant. Both appropriate and inappropriate shocks were recorded along with cause for inappropriate shocks and time to medical assessment.
Research results
RM was associated with fewer inappropriate shocks (13.6% clinic vs 3.9% RM; P = 0.030) and a reduced time to medical assessment (15.1 ± 6.8 vs 1.0 ± 0.0 d; P < 0.001).
Research conclusions
RM in patients with an ICD is associated with both improved patient outcomes.
Research perspectives
The role of RM in other areas should be investigated.
